Summary: How to Change Your Mind

The GIST

How to Change Your Mind by Michael Pollan is a journey into the strange second life of psychedelic drugs. Published in 2018, it sets out to report on how LSD and psilocybin, the active ingredient in magic mushrooms, are being used to bring relief to people with depression, addiction and the terror of a terminal diagnosis. Pollan, best known for his books on food, such as The Omnivore's Dilemma, did not plan to write his most personal book. But a middle-aged, skeptical, fairly strait-laced journalist with almost no psychedelic experience decided he could not write honestly about these molecules without trying them, and the result is part science, part history, part memoir and part travel writing: what his publisher calls a "mental travelogue."

It matters because it overturns a story most of us inherited from the 1960s: that these are drugs that make people crazy. Pollan's case is that, used with care, preparation and a guide, they can far more often help make people sane, and that they open a window onto one of the oldest puzzles there is: what consciousness is, what the self is, and why the adult mind gets so stuck. The book became a number one New York Times bestseller, was named one of the New York Times Book Review's ten best books of 2018, and was later adapted into a four-part Netflix series.

The Big Ideas

A Renaissance

Pollan opens with the claim that psychedelic science, left for dead for decades, has quietly come back to life, and he dates the revival to three events in 2006. The first was a celebration of the hundredth birthday of Albert Hofmann, the chemist who accidentally discovered what the LSD molecule could do. The second was a United States Supreme Court decision allowing a small recognised religion to use the psychedelic brew ayahuasca as a sacrament. The third was a study led by Roland Griffiths at Johns Hopkins, in which healthy volunteers were given psilocybin and many came out calling the session one of the most meaningful experiences of their lives.

Griffiths becomes a central figure in the book, and his work introduces its most surprising idea. Researchers use questionnaires to measure whether a volunteer has had a "mystical experience": a sense of unity, awe and meaning beyond the ordinary self. It turns out that the experience itself, not just the chemistry, seems to do the healing. That makes psychedelics unlike almost any other medicine, and it explains why they unsettle people. As Pollan quotes Griffiths: "There is so much authority that comes out of the primary mystical experience that it can be threatening to existing hierarchical structures."

Bemushroomed

Before the laboratory came the forest. Pollan goes hunting for psilocybin mushrooms in the Pacific Northwest with the mycologist Paul Stamets, and uses the trip to tell the natural history of these fungi and to wonder aloud why a mushroom would bother making a compound that so powerfully alters the human mind.

He also tells how the mushrooms reached the modern West. In 1957, R. Gordon Wasson published an article in Life magazine about his encounter with the Mazatec healer María Sabina in Mexico, and with it the mushrooms were suddenly in front of a mass American readership. The point of the chapter is humbling: what looks like a new science began with a healer's practice, and with a fungus in the woods.

The First Wave: The Promise and the Crack-Up

The heart of the history is a story almost nobody remembers. In the 1950s and early 1960s, psychedelics were among the most promising tools in psychiatry. Hofmann had synthesised LSD at Sandoz. The psychiatrist Humphry Osmond coined the word "psychedelic" and, with Abram Hoffer, used LSD to treat alcoholics in Saskatchewan. A mysterious promoter known as "Captain" Al Hubbard spread the word; Aldous Huxley wrote The Doors of Perception; and the enthusiasm reached therapists, Hollywood and even Bill Wilson, the co-founder of Alcoholics Anonymous.

Then came what Pollan calls the crack-up. At Harvard, Timothy Leary and Richard Alpert ran the Harvard Psilocybin Project, with studies such as the Good Friday Experiment and the Concord Prison Experiment, and Leary turned from researcher into evangelist, urging a generation to "turn on, tune in, drop out." The drugs escaped the clinic and became a symbol of the counterculture. Moral panic followed, then prohibition, and research all but stopped for decades.

Pollan's argument is that this promising science was shut down mainly for cultural and political reasons, not scientific ones. A handful of evangelists, meaning well, set off a backlash that buried the evidence along with the hype. From this period he also draws the most important practical idea in the book: "set and setting." The person's mindset going in, and the surroundings they are in, shape a psychedelic experience as much as the molecule does. The same dose can bring bliss in one room and terror in another.

Journeying Underground

Pollan wanted to know these experiences from the inside, but the clinical trials had no use for a healthy volunteer of his kind. So he found professional guides working underground, outside the law, and took three carefully prepared journeys.

The first, on LSD, was gentle. It centred on his family: his son, his parents, his siblings. His ego stayed intact, and he describes the experience as more of a "novel mode of cognition" than a shattering. For days afterward he felt more positive and more appreciative of ordinary life, and then the glow faded.

The second, on psilocybin, went deeper. Music took on enormous power, some passages were lovely and others upsetting, and it was here that he felt his sense of self dissolve.

The third was the wildest: 5-MeO-DMT, a compound found in the venom of a toad, smoked for a trip that is very short and overwhelmingly intense. It began in sheer terror. He felt as though he were riding a rocket, and then, slowly, reality put itself back together. For a man who calls himself psychologically even, the book is frank about being, in his words, "tossed in a psychic storm of existential dread so dark and violent that the keel comes off the boat."

What did it add up to? Pollan had hoped to find out whether a secular skeptic could have the mystical experience others described. By the researchers' own criteria, both the psilocybin and the toad journeys qualified. He keeps his doubts about whether what people meet in these states is real in any supernatural sense, but he refuses to wave the experience away.

Your Brain on Psychedelics

What is actually happening inside the skull? Pollan is careful to say that the field is still working this out, but a picture is forming. Psychedelics act on the same receptor that serotonin uses, known as 5-HT2A. And brain-imaging work by Robin Carhart-Harris and David Nutt at Imperial College London pointed to something unexpected: psilocybin quiets a set of brain regions called the default mode network.

This network is tied to self-reflection, rumination and the voice in the head that narrates our lives; it is, more or less, the seat of the ego. When it goes quiet, other parts of the brain begin talking to each other more freely. That may explain both halves of the psychedelic experience at once: the feeling that the boundary between self and world has melted, and the loosening of mental habits that had seemed fixed.

Pollan offers two images to make this stick. The first is a snow-covered ski slope. Every thought we repeat is like a run down the hill, and over the years the runs become deep grooves that are very hard to steer out of. A psychedelic is like a fresh fall of snow: for a while, you can go anywhere. The second compares the adult mind with a child's. A child's attention is like a lantern, casting light broadly in every direction. An adult's is a spotlight, narrow and efficient. Psychedelics may give the adult a few hours of the lantern back.

The Trip Treatment

The final chapter takes these ideas into the clinic, under the three headings of dying, addiction and depression. At NYU and Johns Hopkins, cancer patients suffering from anxiety and depression were given psilocybin in guided sessions, and many came away with a large and lasting drop in their fear of death; Pollan tells their stories one by one. At Johns Hopkins, a small pilot study used psilocybin to help people stop smoking. At Imperial College, researchers tried it on depression that no other treatment had touched.

These are very different illnesses, and Pollan's insight is that they may share a root: rigid, repetitive, self-focused thinking, a mind trapped in its own grooves. Psychedelics break that pattern up for a while. And once again it is the experience that seems to be the medicine. The meaning, the awe and the fresh perspective that patients bring back matter more than any lingering chemical effect.

Putting It to Work

This is not a how-to-trip manual, and Pollan does not urge anyone to break the law. What he offers is a new way of thinking about the mind.

• Your default mind is not your only mind. The ego's habits feel like reality, but they are grooves, and grooves can be changed. Pollan suggests that awe, meditation and similar practices may work on the mind in comparable ways, so there is something here even for people who will never touch a psychedelic.
• Context is everything. Set and setting decide what kind of experience someone has. In the research, safety depends on screening, careful preparation, a trusted guide, a calm room and "integration" afterward, the slow work of making sense of what happened.
• Take the risks seriously. Frightening trips are real, and these drugs are dangerous for people with a personal or family history of psychosis. Pollan treats the field's uncertainty as honestly as its promise.
• Value more than one kind of consciousness. In his epilogue, Pollan argues for "neural diversity". He believes the value of these substances goes beyond treating illness, to the betterment of well people, and has said elsewhere that they are for spiritual experience, self-exploration, setting priorities and breaking habits.
• Spirituality doesn't require the supernatural. Pollan came away more open and more emotionally available, and willing to use the word "spiritual" in a secular sense: connection, and getting beyond the ego.

Who Should Read It

Curious skeptics above all: readers who would never go near a psychedelic but want to understand why serious scientists at Johns Hopkins, NYU and Imperial College are studying them. It will also reward anyone interested in consciousness and the brain, anyone touched by depression, addiction or the fear of dying, and anyone who loves a well-told piece of participatory journalism by a writer willing to risk his own composure to find out what is true.

This has been a summary of How to Change Your Mind by Michael Pollan, giving you the GIST so you can decide if you want the REST.